Evaluation of patient referrals to family physicians in Georgia

Abstract

Background. Adequate utilization of primary care directly reflects the health status of the population. In Georgia (Republic), many patients seek care without a referral by a primary-care provider, and as a result, patient referral rates to family physicians are low. A tendency of patient self-referral behavior may reduce the effectiveness of the healthcare system. Objectives. The purpose of the research is to study the problem of the low rate of patient referrals to family physicians in Georgia. Material and methods. Within the quantitative survey, 20 family physicians and 300 patients were interviewed through a semi-structured questionnaire in different regions of Georgia. Results. Patient referral rates to family physicians are low. 15% (n = 3) of family physicians recognize that patients often address them only for a referral to specialists. Only 5% (n = 3) of family physicians provide preventive consultations on occasion and 50% (n = 10)-in the case of need only. 70% (n = 14) of family physicians think that their remuneration is not adequate for their work and that they work more than they are paid. 35% (n = 105) of respondents in the case of a health problem address both a family physician and a specialist-physician. 42% (n = 126) of patients visit a family physician once a year or do not visit at all, and 47% (n = 141) of patients believe that the family physician institute needs some changes. Conclusion. The result suggests that the low rate of patient referrals to family physicians is due to distrust towards family physicians, which is related to a lack of qualification of physicians and low public awareness of the competence of the family physicians. Due to inadequate reimbursement, family physicians do not have enough motivation to provide adequate service, and the lack of continuous professional education negatively affects their professional development. It is recommended to raise public awareness about primary care, to introduce effective methods for payment of family physicians and to increase the role and affordability of continuous professional education.

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“…Macerated stillbirth rate tends to increase in most referral maternity centers as a result of the pooling together of hitherto poorly managed and complicated cases to such centers from lower levels of maternity care in the health care system. Where referrals within the healthcare system are not appropriately utilized as is obtained in Georgia where referrals to primary care providers are low, the effectiveness of that healthcare system could be reduced (Verulava et al, 2019). Notwithstanding, an institutional based study in Enugu, South-east Nigeria had recorded 47.7% of macerated stillbirth as against a fresh stillbirth rate of 52.3% (Goldenberg, McClure and Belizán, 2009;Ezugwu et al, 2011).…”

Factors influencing medical students’ choice of family medicine

“…In order to provide a high-quality primary health care system, qualified family doctors are needed [1]. The extremely low number of properly qualified family physicians is a worldwide problem [2,3].…”

Assessment of formats and completeness of paper-based referral letters among urban hospitals in Rwanda: a retrospective baseline study

“…This is an important concept of care coordination whereby healthcare professionals work together to ensure patients receive all the services needed, completed by the continuity of care in which comprehensible and well-organized health care events are performed across a variety of health settings [ 3 ]. Hence, patient information exchange is vital to achieve quality service delivery through appropriate coordination and continuity of care [ 4 , 5 ].…”